Which adjunct is given with antibiotics in suspected bacterial meningitis to reduce inflammation?

• A. Dexamethasone
• B. Acyclovir
• C. Acetaminophen
• D. Ibuprofen

Answer: (A)

In suspected bacterial meningitis, the inflammatory damage in the meninges is driven by the body's response to the dying bacteria once antibiotics start. Administering a corticosteroid like dexamethasone before or with the first dose of antibiotics helps blunt that inflammatory cascade, reducing meningeal edema, intracranial pressure, and potential neurologic sequelae such as hearing loss. Dexamethasone is specifically used for this purpose because of its strong anti-inflammatory effects and good CNS penetration. The other options don’t target this inflammatory injury: acyclovir treats viral encephalitis, not bacterial meningitis; acetaminophen and ibuprofen provide symptomatic relief but don’t reduce meningeal inflammation or prevent neurologic damage from the meningitis process.